A lower-middle-class American ponders the things others might do with his money.

Friday, December 20, 2013

Reason #307: I Actually Signed Up For Obamacare

People keep asking me questions about this, so I figured I'd just start from the beginning.

A year ago, I was on the best employer health insurance plan I'd ever had. That's not saying too much, as I've never made enough money to have a really good plan, but I happen to have certain specific ongoing medical needs that cost a not-insignificant amount of money, so for me, the difference between a "good" plan and a "bad" plan is either paying UPMC upwards of $100 per month just to keep my debt to them leveled off...or paying a $50 copay once or twice a year. And the plan I was on a year ago was the first ever to land me in the latter situation.

Then the re-enrollment period came up last July, and my employer was dumped from the plan. We're a pretty big company, but still small enough that if a handful of people get really sick in a short period of time--which is apparently what happened--it can tilt the entire company's insurance situation from profitable to not profitable. So there I was, fresh out of a $1500 medical procedure that had only cost me $50, learning that that would no longer be an option.

The two options I had going forward were thus: a roughly equivalent plan to the good one with a 70% increase in my premium, or a worse plan...with a 30% increase in my premium. Said premium was already on the high side, but it was virtually eliminating my medical expenses, so I was okay with it--but 70% more wasn't happening. So onward I went into the second half of 2013, with less medical coverage and a smaller paycheck to show for it.

Suffice it to say, I was happy to give Obamacare a shot. It's ironic that insurance companies rejiggering their rates in anticipation of the health care exchange might have had a hand in my employer costs going up, because if everything had stayed the same I'd have been happy to keep my employer plan.

I started an account on healthcare.gov within the first couple weeks of October--even before all the website nonsense started, I wasn't in a big hurry, because I know enough about the tech industry to expect problems with any big launch. Buying an iPod the day it comes out is stupid, and trying to get health care on day one of the exchange would have been equally stupid. So by the time I got around to making the account, I was well aware of the problems and was just expecting to dip my toes in. I started the account itself, entered most of my personal info with no problems, and eventually they wanted some information on my employer coverage that I wanted to confirm with HR first, so I stopped there. I had the info within a couple days, but I figured I might as well leave it be until things seemed to be going better with the site.

Cut to the beginning of December. Word was they'd mostly met their deadline of making the site usable by the end of November, but there were still problems with the "back end"--meaning people would sign up for a plan but the information wasn't being passed along to the insurers correctly--so my thinking was, better to get signed up soon enough that I would have time to make sure everything went through properly before the end of the year. On December 12th, I logged back in, finished off my profile stuff, and started looking at plans. The website wasn't perfect; not all the navigation options were as intuitive and/or reliable as they could have been, but nothing that really hurt my ability to use it--I've been a Chrome user since the beta, so I'm used to having the occasional hiccup on certain websites. No big deal.

Meanwhile, without too much digging, I found a plan that was pretty close to that old one I had liked, for just about the same amount of money (which, remember, meant it would be cheaper than what I'm paying right now). The exchange gave me an "eligibility notice" based on my personal financial information that told me I might qualify for a tax subsidy, but weirdly, the cost for the plan included a listing for my subsidy, but listed said subsidy as zero dollars. Checking the fine print of my eligibility notice, I saw a message that basically said they'd need more time to look into my situation and determine what kind of tax break I could have--but the base cost of my plan was still acceptable to me, and in the interest of getting this over with I decided I'd go ahead and enroll either way. I clicked the button to do just that, and it went through okay, but then it gave me a link to make a payment on the insurer's website. I didn't want to go quite that far until I was sure about the subsidy thing--and sure that the paperwork for the plan had actually gone through correctly--so rather than actually make a payment, I called the exchange's hotline and was talking to someone within five minutes. She was very friendly, but admittedly didn't have much specific information for me. She told me that I would be hearing from the insurer shortly to finalize things, and that when that happened I could go ahead and pay them without losing my chance at a subsidy in the event that I was ultimately able to get one.

A week goes by. My plan status is still listed on my exchange account as "initial enrollment", but I haven't gotten any mail or phone calls from the insurer yet. The hotline lady gave me a direct number for the insurer that I could call if I wanted to follow up myself, so I called it this morning and, well, it was a useless number. I couldn't get through their menu options without a plan ID number that I didn't have yet, and every time I tried to get an operator it hung up on me. I was not optimistic.

So I tried Googling the name of my plan, and I found a PDF "summary of benefits" document on the insurer's website that had the company's general customer service number on it--that seemed like a safe bet. So I called that one, and got a human being almost immediately. Normally I'm one of the few people that prefers talking to robots on the phone, but given that I wasn't even sure I existed in their system at all it was a relief to be able to just tell someone what my situation was. To my even greater relief, she found my records right away and confirmed that everything the exchange had told me was correct and my first bill was en route. It'll probably show up sometime next week, but since I'm leaving town for Christmas I decided to just get the first payment taken care of over the phone, so she transferred me to billing and 5-10 minutes later I was done--and officially Obamacare's newest success.

I still haven't heard anything new about my tax subsidy, of course, and I'm not optimistic; I do know that I make well under the $44 thousand per year or so that's supposed to be the line for one-person households to qualify, but it's possible there's some other extenuating circumstance I don't know about. Maybe I'll hear something, maybe not--even if I'm stuck at this price for 2014, maybe sometime next year I'll call the exchange again and investigate further, but frankly, I'm already perfectly content with what I'll be paying; it's not dirt cheap, but at least I had dozens of plans to choose from instead of two.

My sense of the new system overall is that it's not likely to be immensely cheaper unless you really do manage to qualify for some huge tax subsidy, but even if the price difference is a wash, it's infinitely preferable to have the option to browse through a bunch of different plans and pick the one with the best details, rather than just have to take whatever my job happened to offer, or research a million different private insurance plan on my own. Having healthcare.gov available as the Orbitz or Travelocity of health insurance is definitely a great thing, even if the value element is hard to predict.

1 comment:

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